Pontine Warning Syndrome: Case Series and Review of Literature

Muengtaweepongsa, Sombat; Singh, Niranjan; Cruz‐Flores, Salvador

doi:10.1016/j.jstrokecerebrovasdis.2009.06.008

Cited by 25 publications

(28 citation statements)

References 25 publications

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“…3). The crescendo transient ischemic attacks involving the callosal body culminating in ischemic infarction and persistent symptoms were in keeping with the temporal profile of warning syndromes that has been described for capsular and pontine tegmental strokes [1][2][3][4]. The predominant pathophysiologic mechanisms underlying these stroke warning syndromes include hemodynamic compromise of penetrating arterial branch and peri-infarct depolarization [1,2].…”

Section: Discussionsupporting

confidence: 75%

“…For instance, when the recurrent episodes of transient hemiparesis are followed by infarction in the internal capsule, it is called capsular warning syndrome [1,2]. On the other hand, when the corresponding infarction heralded by transient events occurs in the region of the pontine tegmentum, it is termed as pontine warning syndrome [3,4]. In this communication we report on a novel stroke syndrome that is characterized by initial fluctuating symptoms of corpus callosal disconnection followed by an ischemic infarction in the same region.…”

Section: Introductionmentioning

confidence: 98%

“…Stroke warning syndrome refers to a cerebrovascular syndrome that is characterized by recurrent, stereotyped episodes of transient neurological symptoms and signs leading up to infarction in the corresponding anatomical site [1][2][3][4]. Based on the neuroanatomical location of the final infarction, the syndrome has been given the corresponding name.…”

Section: Introductionmentioning

confidence: 99%

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Callosal warning syndrome

Nandhagopal

Al‐Asmi

Johnston

et al. 2012

Journal of the Neurological Sciences

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Section: Discussionsupporting

confidence: 75%

Section: Introductionmentioning

confidence: 98%

Section: Introductionmentioning

confidence: 99%

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Callosal warning syndrome

Nandhagopal

Al‐Asmi

Johnston

et al. 2012

Journal of the Neurological Sciences

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“…Deterioration can also follow spontaneous improvement 132 as a result of persistent occlusion or partial recanalization with subsequent reocclusion 133 and often results in a worsening of deficits back to baseline severity. Lacunar strokes involving the pons commonly fluctuate 134 yet often lead to progressive worsening of deficits later. 135 Many patients with stroke with initial rapid improvement are ultimately disabled.…”

Section: Rapidly Improvingmentioning

confidence: 99%

Scientific Rationale for the Inclusion and Exclusion Criteria for Intravenous Alteplase in Acute Ischemic Stroke

Demaerschalk¹,

Kleindorfer²,

Adeoye³

et al. 2016

Stroke

550

237

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Purpose-To critically review and evaluate the science behind individual eligibility criteria (indication/inclusion and contraindications/exclusion criteria) for intravenous recombinant tissue-type plasminogen activator (alteplase) treatment in acute ischemic stroke. This will allow us to better inform stroke providers of quantitative and qualitative risks associated with alteplase administration under selected commonly and uncommonly encountered clinical circumstances and to identify future research priorities concerning these eligibility criteria, which could potentially expand the safe and judicious use of alteplase and improve outcomes after stroke. Methods-Writing group members were nominated by the committee chair on the basis of their previous work in relevant topic areas and were approved by the American Heart Association Stroke Council's Scientific Statement Oversight Committee and the American Heart Association's Manuscript Oversight Committee. The writers used systematic literature reviews, references to published clinical and epidemiology studies, morbidity and mortality reports, clinical and public health guidelines, authoritative statements, personal files, and expert opinion to summarize existing evidence and to indicate gaps in current knowledge and, when appropriate, formulated recommendations using standard American Heart Association criteria. All members of the writing group had the opportunity to comment on and approved the final version of this document. The document underwent extensive American Heart Association internal peer review, Stroke The American Heart Association makes every effort to avoid any actual or potential conflicts of interest that may arise as a result of an outside relationship or a personal, professional, or business interest of a member of the writing panel. Specifically, all members of the writing group are required to complete and submit a Disclosure Questionnaire showing all such relationships that might be perceived as real or potential conflicts of interest.This statement was approved by the American Heart Association Science Advisory and Coordinating Committee on September 24, 2015, and the American Heart Association Executive Committee on October 5, 2015. A copy of the document is available at http://my.americanheart.org/statements by selecting either the "By Topic" link or the "By Publication Date" link. To purchase additional reprints, call 843-216-2533 or e-mail kelle.ramsay@ wolterskluwer.com.The online-only Data Supplement, which contains literature search strategies and Figures A, B, and C, is available with this article at http://circ. ahajournals.org/lookup/suppl/doi:10.1161/STR.0000000000000086/-/DC1.The American Heart Association requests that this document be cited as follows: Demaerschalk BM, Kleindorfer DO, Adeoye OM, Demchuk AM, Fugate JE, Grotta JC, Khalessi AA, Levy EI, Palesch YY, Prabhakaran S, Saposnik G, Saver JL, Smith EE; on behalf of the American Heart Association Stroke Council and Council on Epidemiology and Prevention. Scientific rational...

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“…Since the original description of this phenomenon, other investigators have described the ‘pontine warning syndrome' caused by stroke in the paramedian pons, describing fluctuations in gaze palsies, dysarthria and ataxic hemiparesis [2,3,4]. The following case exemplifies the way that fluctuations can continue even when infarction is already present.…”

mentioning

confidence: 88%